The dyspnoea of asthma & bronchitis : its causation, and the influence of nitrites upon it / by Thomas R. Fraser.

  • Fraser Thomas R. (Thomas Richard), Sir, 1841-1920.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The dyspnoea of asthma & bronchitis : its causation, and the influence of nitrites upon it / by Thomas R. Fraser. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    assumes the most varied attitudes in order to appease in a measure his craving for air. . . . Soon the -patient hurries to the window to struggle for a mouthful of fresh air. In spite of all this, he does not appease his craving for air, even, by the forcible action of all his auxiliary muscles. The paroxysm, continues at its height for a long time—one, two, or more hours—and then it gradually subsides. The respiration becomes: easier again, the cyanosis dis- appears, the patient gradually i§,^ls; freer and freer, and then drops off into a quiet, deep, uuinterrujited sleep.” Now, what is the cause ofrthis intense and distressing dyspnoea? No anatomical lesions, are found which are sufficient to account for it. It is regarded as a functional disorder produced by altera- tions in normal physiological conditions, or by temporary structural changes which disappear with the asthmatic paroxysm. Speculation has been active, however, in advancing hypotheses regarding the nature of the functional or temporary structural disturbances which so obviously produce an obstruction to the movement of air along the respiratory passages. Setting aside the theories that were originated previously to the discoveries of Lsennec and Auenbrugger in physical diagnosis, when asthma was a term applied not only to pulmonary dyspnoea, but also to the dyspnoea of diseases of the heart and large bloodvessels, of the pleura, glottis, stomach, and other organs and parts of the body remote from the lungs, it is probable that the first certain and firm basis of knowledge as to its causation was supplied by the demonstration by Eeisseissen,^ Prochaska, and Kolliker, of the existence of a muscular structure in the bronchi. The demonstration of the contractile power of this muscular structure by Williams^ and Longet,® amply confirmed by the subsequent experiments of Paul BerP^ and others, led to a revival of the old and, for a time, discredited view, that asthma is pro- duced by a spasmodic affection of the muscles and nerves of respiration. The asthma convulsivum of Willis then became the asthma of bronchial spasm of Cullen, Romberg, Bergsen, Trousseau and Salter; and for more than half a century was the generally accepted doctrine, notwithstanding the enunciation of other theories, usually of a purely speculative character, such as those of Todd, Br4e, Budd, Walshe, and others. The most formidable attacks made on the theory of bronchial spasm, however, were probably those of Wintrich, in 1854, and of Weber, in 1872 ; as the important hypothesis of Leyden,® that the asthmatic paroxysm is produced by irritation of the vagus termina- ^ Ueber den Ban der Lungen. Berlin, 1822. ^ of ihe British Association for the Advancement of Science 1840, p. 411. •' 3 Gomptes rendus des sciences, 1842, t. xv. p. 500. Legons sur la physiologic comparde de la respiration, 1870. p 379 « Virchow’-s Archiv, 1872, Bd. 54, p. 324. >